Provider Demographics
NPI:1306045331
Name:DECHENNE, KARI MELISSA (MD)
Entity Type:Individual
Prefix:DR
First Name:KARI
Middle Name:MELISSA
Last Name:DECHENNE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KARI
Other - Middle Name:MELISSA
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:KARI DECHENNE
Mailing Address - Street 1:1211 ALEKOKI ST
Mailing Address - Street 2:
Mailing Address - City:WAHIAWA
Mailing Address - State:HI
Mailing Address - Zip Code:96786-7087
Mailing Address - Country:US
Mailing Address - Phone:757-876-2420
Mailing Address - Fax:
Practice Address - Street 1:440 HOPKINSVILLE ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:KY
Practice Address - Zip Code:42345-1124
Practice Address - Country:US
Practice Address - Phone:270-338-8000
Practice Address - Fax:270-338-8333
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY47104207P00000X, 207Q00000X
HIMD-19283207P00000X
VA010124512207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004900529Medicaid
RES000Medicare UPIN
490052Medicare PIN